A&E at DGH is safe but hundreds of patients will face travel for treatment

Andrew Slater, medical director at DGH
Andrew Slater, medical director at DGH

THE accident and Emergency department at the DGH will not be downgraded although other services look increasingly likely to be centralised at either the Conquest in Hastings or in Eastbourne – a move which will leave hundreds of patients a year having to travel 20 miles or more for treatment.

Earlier this week the Herald spoke to Andrew Slater, East Sussex Healthcare Trust’s medical director, who is one of the team responsible for the controversial plans to move some key services to a single site rather than provide them at both of the area’s main hospitals.

He denied the mooted changes had anything to do with cost-cutting and reiterated the Trust’s line that, rather than reduce services, the plans would actually improve the level of care provided locally.

Dr Slater (pictured) announced on Monday the Trust would begin consulting the public about changes to surgery. stroke and orthopaedic services with people asked where they felt the departments were most needed.

This information will then be added to by discussions with patient groups and GPs before a final decision is made on the future of both hospitals. The likely upshot is each department will be centralised at one hospital or the other.

He said the Trust was ‘absolutely committed’ to providing two acute hospitals and followed it up by saying, “We have taken a real honest look about how we provide these services, what we are actually providing, and how we can improve it to bring about a gold standard of health care.”

However, he did admit that while lower level treatments and consultations for each specialist area would still be available on both sites, the Trust estimated around 15 people a day would have to travel to the other hospital for high end emergency care.

As the hospital operates 365 days a year, that figure will sit at around 5,475 people inconvenienced every 12 months.

When quizzed as to why the people of both towns could not expect expert facilities at their local hospital, Dr Slater said the Trust had found itself hamstrung by a lack of available consultants.

He again denied the problems were down to the Trust’s finances, which have been shown to be less than perfect in recent years, saying, “We have found that despite having the funding we are not attracting the specialist doctors and nurses in every area and that has been incredibly disappointing. There are other hospital trusts out there with a similar vision and they (consultants) are choosing to work there.”

He added there needed to be what he called a critical mass of patients to make the Trust more attractive and provide doctors and nurses with enough work to maintain their specialist skills.

Stroke care, he said, was a perfect example. “Across the Trust we have around 750 stroke patients a year but that does not give the specialists that critical mass.

“In London there were around 30 stroke units and these were reduced to eight, which provided high acute stroke care and over the last 18 months around 400 lives have been saved directly as a result of this configuration.

“The average length of stay has fallen and quality of life indicators have shown a clear and dramatic improvement in care.”

He hopes for a similar turnaround once the service has been centralised in East Sussex.

“This is all about being able to attract, recruit and retain specialist doctors and nurses,” he added, “In a year’s time there will be specialist stroke nurses seven days a week, 365 days a year.”

The Herald attempted to press Dr Slater on the future of maternity, with Save the DGH campaigners warning that once one service heads to Hastings, others will fall like a deck of cards.

Dr Slater refused to be drawn on the subject, saying only that talks over the department’s future were at “the very start” and had not reached anywhere near the same level as the three already earmarked for changes.

His stance though will have done little to reassure locals after a similar study said the best option was to operate a consultant-led unit at just one of the hospitals.

One area of comfort though was his firm, on-the-record commitment to maintaining A&E. In fact, he promised further investment.

“We do not have enough A&E consultants,” he said, “and are looking to increase that number at both sites.”

That commitment, he argued, showed how seriously the Trust takes its responsibility and said East Sussex Healthcare was determined to keep both hospitals at the heart of their respective communities.

All that considered though, it is an inescapable fact that some patients will face the upheaval of travelling for their care.

“We have huge sympathy and understand the inconvenience for patients having to move between the sites,” he said, “but the quality of services they get in return will far outweigh the inconvenience.”

And he said it was important the changes were not seen as a direct fight between Hastings and Eastbourne, saying there would be no direct trade off of services. Each department would go where it best met need – even if that meant every service being centralised in Hastings. “It cannot be a question of playing cards,” he said. “We should make the decision that will benefit all the patients in East Sussex so this is why we are asking the public for their views on where these services should be sited.

“We are looking at the demographics and travel time. This is not about winners and losers, it’s about providing high quality care for patients in East Sussex.

“Outpatients appointments will stay where it’s most convenient for the patient. If you need an x-ray or other test, that again will be at the hospital most convenient to you, as well as day-case surgery in any of these three services.

“If the patient has all but the highest risk surgery that needs to be done, that will be carried out at the hospital most convenient to them.

“No decision will be taken lightly. I live in this area and want the best service possible. If that means centralising some departments than that is what we should do. It is not about downgrading. Getting to a hospital quickly but not getting as good a level of care does not do anyone any good.”

The consultation runs until September 28 and can be filled in online at www.esht.nhs.uk/shapingourfuture or a paper copy is available by call 01273 485300.